Saving A Leg . . . And A Life

Boca Raton Surgeon Plans To Operate On Former Bosnian Soldier

A former Bosnian soldier, his right leg ravaged by infection, faced amputation as the only way to save his life.

Even if they were willing to operate and clean out dead tissue feeding bacteria in the leg, doctors in his native country didn't have new-generation antibiotics to promote healing.

They tried tetracycline, which didn't work.

Cutting off his leg, they told Milodrag Grubisic, 34, was their only option.

But Dr. Charles Stewart, an orthopedic surgeon from Boca Raton, looked at Grubisic's X-rays last October and saw a different picture.

Armed with the newest and most powerful antibiotics, he was confident he could save the leg.

Stewart learned about the case from a Delray Beach priest and the head of a Croatian relief organization, and he has scheduled surgery for today.

``In a country where the choice is saving one leg or inoculating 1,000 children, vaccinations will win out,'' Stewart said.

``There are limited resources, and they must be rationed. Mr. Grubisic was not only a victim of war, but a victim of the medical system.''

Grubisic, the father of four children under age 14, was injured in August 1992 when a bomb blew up during fighting in Mostar against Muslims on the ground and Serbs in the mountains.

The explosion threw him from his four-wheel-drive vehicle, crushing his femur and tibia.

Six surgeries, one in which a large metal plate and 10 screws were used to repair the femur, left him with the right leg two inches shorter than the other and afflicted with severe arthritis.

But the pain from the infection was even more severe.

``Some nights I screamed so loud from the pain that the entire village heard me,'' Grubisic said through an interpreter, Maria Paulic of Croatian Relief Services of Florida. He lives in Grude, Bosnia-Herzogovina _ population 20,000.

Paulic and the Rev. Jack Barrow of St. Vincent Ferrer Catholic Church in Delray Beach met the injured soldier during a trip to Herzogovina last year. Barrow then brought the X-rays back to Dr. Stewart to evaluate.

In those black-and-white films that show the metal plate and 12 screws, he saw a lot of hope.

``My immediate reaction was, `No, no, tell them not to amputate,' '' Stewart said on Monday. ``I think I can save that leg.''

Grubisic is scheduled for surgery at 10:30 a.m. for an hourlong operation. The orthopedic surgeon is donating his services, and Boca Raton Community Hospital is donating an operating room, nurses and anesthesia services.

``I enjoy my work immensely, and any time I can help someone out, I will,'' Stewart said. ``In this case, we intend to save a leg and get a guy home to raise his children.''

Stewart said he will remove the hardware, clean out dead tissue from the affected area and administer the appropriate antibiotics once the type or types of bacteria causing the infection are identified by a hospital pathologist.

``There might be more than one type of infection in there,'' Stewart said. ``There's a 60 percent chance or better that we are dealing with staphylococcus, but there could be a fungal infection, as well.''

Grubisic has been in the United States for a month, staying at Paulic's home in Miami. With every one of his phone calls home, the emotion builds, his host said.

He is particularly close with his 5-year-old son, Slavko, who was born shortly after the bomb explosion and has never seen his father without crutches.

``The little one was sobbing on the phone the other day _ he misses his father so much,'' Paulic said. ``It's very rough for Milodrag and for his family. But, hopefully, he will be able to go home soon. It's all in God's hands.''